A combined group treatment for nightmares and insomnia in combat veterans: A pilot study

Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 12/2009; 22(6):639-42. DOI: 10.1002/jts.20468
Source: PubMed


Insomnia and nightmares are hallmarks of posttraumatic stress disorder (PTSD). Sleep disturbances in PTSD negatively impact clinical course and functioning. In this open clinical trial, the preliminary effects of a combined treatment for insomnia and nightmares in combat veterans with PTSD were assessed. Ten combat veterans participated in a 10-session group treatment combining cognitive-behavioral therapy for insomnia with exposure, rescripting, and relaxation therapy. Participants maintained daily sleep and dream diaries and completed self-report measures of sleep quality and PTSD symptoms pre- and posttreatment. Participants reported improvements in sleep and nightmares following treatment. Future research using controlled designs to evaluate this treatment is warranted.

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Article: A combined group treatment for nightmares and insomnia in combat veterans: A pilot study

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    • "A limited number of studies have tested CBTI in the veteran population yet all found significant improvement in sleep outcomes including primary and comorbid insomnia (Edinger & Sampson, 2003; Germain et al., 2012; Swanson, Favorite, Horin, & Arnedt, 2009; Ulmer, Edinger, & Calhoun, 2011). Three studies used cognitive-behavioral intervention components for insomnia and imagery rehearsal therapy (IRT) for nightmares, a problem commonly associated with PTSD (Germain et al., 2012; Swanson et al., 2009; Ulmer et al., 2011). The number of treatment sessions ranged from two to ten in-person sessions. "
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    • "Nightmares not only disrupt sleep but also may lead to anticipatory anxiety about experiencing nightmares.53,54 To address these issues, CBTI was combined with exposure to the nightmare content or imagery rehearsal therapy (IRT).54 IRT suggests to patients that, over time, nightmares become a learned experience and recommends altering (rescripting) the content of dreams by activating the imagery system.55,56 "
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